ABSTRACT

Objectives  While morphological abnormalities of the pubovisceral muscle have been described on magnetic resonance imaging (MRI), their relevance remains unclear. This study was designed to define prevalence and clinical significance of such abnormalities in urogynaecological patients. Design  Prospective observational study. Setting  Tertiary urogynaecological clinic. Population  Three hundred and thirty‐eight consecutive women referred for urodynamic assessment. Methods  Participants underwent a clinical assessment, multichannel urodynamics and imaging with 3D translabial ultrasound. Blinded offline analysis was performed with the software 4D View (GE Kretztechnik, Zipf, Austria). Main outcome measures  Major morphological abnormalities of the pubovisceral muscle. Results  Defects of the pubovisceral muscle were found in 15.4% of parous women. They were exclusively anteromedial (uni‐ or bilateral), only occurred among women who had delivered vaginally and were associated with anterior and central compartment prolapse (all P < 0.001). There was no association with symptoms of bladder dysfunction or urodynamic findings. Conclusions  Major morphological abnormalities of the pubovisceral muscle are common in parous urogynaecological patients. They are associated with prolapse of the anterior and central compartment, but not with symptoms of bladder dysfunction or urodynamic findings.

Objectives

There is evidence from the present pilot study suggesting that women with pelvic floor muscles hypertonicity and pelvic pain may respond to BOTOX injections into the pelvic floor muscles. Further research into this novel treatment of chronic pelvic pain is strongly recommended.